Objectives. The association of periodontal disease in people diagnosed with RA is emerging as an
important driver of the RA autoimmune response. Screening for and treating periodontal disease might
benefit people with RA. We performed a systematic literature review to investigate the effect of
periodontal treatment on RA disease activity.
Methods. Medline/PubMed, Embase and Cochrane databases were searched. Studies investigating
the effect of periodontal treatment on various RA disease activity measures were included. The quality
of included studies was assessed. Data were grouped and analysed according to RA disease outcome
measures, and a narrative synthesis was performed.
Results. We identified a total of 21 studies, of which 11 were of non-randomized experimental design
trials and 10 were randomized controlled trials. The quality of the studies ranged from low to serious/
critical levels of bias. RA DAS-28 was the primary outcome for most studies. A total of 9 out of 17
studies reported a significant intra-group change in DAS-28. Three studies demonstrated a significant
intra-group improvement in ACPA level after non-surgical periodontal treatment. Other RA biomarkers
showed high levels of variability at baseline and after periodontal treatment.
Conclusion. There is some evidence to suggest that periodontal treatment improves RA disease
activity in the short term, as measured by DAS-28. Further high-quality studies with longer durations of
follow-up are needed. The selection of the study population, periodontal interventions, biomarkers and
outcome measures should all be considered when designing future studies. There is a need for
well-balanced subject groups with prespecified disease characteristics.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)